Provider Demographics
NPI:1912105685
Name:CARPENTER, GINA BEISER (DC)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:BEISER
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1399 SCENIC HWY N # 124
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2125
Mailing Address - Country:US
Mailing Address - Phone:770-985-9995
Mailing Address - Fax:770-985-9710
Practice Address - Street 1:1399 SCENIC HWY N # 124
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2125
Practice Address - Country:US
Practice Address - Phone:770-985-9995
Practice Address - Fax:770-985-9710
Is Sole Proprietor?:No
Enumeration Date:2007-07-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR005661111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU69190Medicare UPIN